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Background: Carbapenems are often used as last-line agents for treating serious healthcare-associated infections (HCAIs) caused by multidrug-resistant strains. Moreover, increasing resistance to this class of antibiotics has been a major concern worldwide. In the present study, we report the prevalence and molecular characteristics of CPE among intensive care unit patients from university hospitals in Sari, North of Iran.
Materials and Methods: One hundred non-repeated clinical specimens were obtained from hospitalized patients in ICUs of four teaching hospitals in Sari, North of Iran. The API 20E system was used to identify the Enterobacteriaceae. Antibiotic susceptibility testing was performed by the disk diffusion and E-test methods. Subsequently, the MHT and CDT tests were used to identify carbapenemaseproducing clinical isolates, and polymerase chain reaction (PCR) was used to detect the presence of NDM-1, VIM, and OXA-48 genes in the isolates’ chromosomal DNA.
Results: The most enterobacterial isolates in the present study included Escherichia coli (37%), Klebsiella pneumoniae (21%), and Serratia rubidaea (10%), respectively. The most and least effective antibiotics against the clinical isolates were amikacin and meropenem, with resistance rates of 24% and 73%, respectively, while 51% of the isolates were imipenem-resistant. Also, 58 isolates were detected as multidrug resistant (MDR) of which all of them were carbapenem-resistant. Among 73 carbapenem-resistant isolates, 35 (47.9%) and 33 (45.2%) of them were MHT and CDT positive, respectively. Moreover, 30.1%, 31.5%, and 38.3% of these isolates contained VIM, NDM-1, and OXA-48 carbapenemase encoding genes, respectively.
Conclusions: This work demonstrates that the MHT is not a reliable test for the study of strains producing OXA-48 or VIM carbapenemases. Additionally, there was a significant association between the presence of carbapenem resistance genes and K. pneumoniae isolates. It seems that the presence of at least two of these genes can be one of the main reasons for resistance to carbapenems in Enterobacteriaceae.

Background: Helicobacter pylori is a gram-negative, microaerophilic bacterium and a major etiological agent of various gastrointestinal disorders, including gastritis, peptic ulcer disease, and gastric cancer. Given the high prevalence of this infection in Iran, identifying factors influencing its transmission is crucial.
Methods: This descriptive cross-sectional study was conducted in 2023 on 71 patients presenting with dyspepsia at the Amir-al-Momenin Educational and Treatment Center in Gerash, Iran. The initial diagnosis was performed using the Urea Breath Test (C14), with molecular confirmation by PCR. Gene expression analysis of vacA and fliA was conducted using SYBR Green Real-Time PCR. Data were analyzed with SPSS version 25 using the t-test and Chi-square test.
Results: Among 71 participants, 51 (71.8%) were infected with H. pylori. Prevalence was significantly higher in individuals aged 40 years or older and in those of lower socioeconomic status (P<0.05). High consumption of fast food and sweets was also associated with increased infection risk. Molecular analysis revealed high expression of the vacA gene in 82% and of the fliA gene in 76% of infected patients, indicating the presence of highly pathogenic strains in this region.
Conclusion: The findings suggest that lower socioeconomic status, unhealthy dietary habits, and increasing age are significant contributors to the high prevalence of H. pylori in Gerash. Implementing educational initiatives, improving sanitary conditions, and promoting dietary modifications could effectively reduce the burden of this infection.

In low- and middle-income countries (LMICs), where access to screenings and preventative care is restricted, cervical cancer continues to pose a serious threat to world health. In these areas, it is the third most prevalent cancer among women, and increased incidence and mortality are a result of resource inequities. The human papillomavirus (HPV), a sexually transmitted infection, is the main cause of cervical cancer. Nonetheless, studies reveal a complex interplay among environmental, genetic, and epigenetic factors, with mounting evidence supporting the role of the cervicovaginal microbiome. This microbial community controls vaginal health and modulates HPV risks, with some bacterial species, such as those linked to bacterial vaginosis (e.g., Lactobacillus iners), potentially promoting HPV persistence and cervical dysplasia. On the other hand, beneficial species, including Lactobacillus crispatus and Lactobacillus gasseri, contribute to an acidic environment that counters inflammation and may limit HPV progression. Although progress has been made in understanding these dynamics, much remains unknown about the factors influencing microbiome variability and how to manipulate it to prevent disease. Meanwhile, established preventive measures, such as HPV vaccination, routine screenings, and early treatment of precancerous lesions, have proven effective. However, logistical and financial challenges in LMICs hinder broader implementation. To reduce the global burden, efforts must focus on affordable vaccines, integrated screening services, and increasing public awareness. Further microbiome research offers hope for innovative prevention and treatments. Addressing systemic barriers and advancing knowledge could signify meaningful steps toward eradicating cervical cancer as a public health threat worldwide.

 Invasive fungal diseases are an escalating global health crisis, causing an estimated 6.5 million severe infections and up to 3.8 million deaths each year. Their disability burden likely reaches tens of millions of DALYs, yet remains underestimated because of sparse data and profound diagnostic gaps, especially in low- and middle-income countries. This narrative review synthesizes current evidence on three converging domains: the global burden and ecology of invasive fungal disease, the crisis of antifungal limitation and resistance, and emerging One Health responses. We summarize updated mortality, morbidity, and cost estimates and describe how demographic ageing, expanding immunosuppression, COVID-19, climate change, and agricultural azole fungicide use are enlarging the population at risk and selecting for resistant strains. Four WHO priority pathogen groups—Candida auris, azole-resistant Aspergillus fumigatus, Cryptococcus species, and Mucorales—are used to illustrate patterns of emergence, healthcare transmission, environmental selection, and multidrug resistance, linked to underlying molecular mechanisms such as ERG11 and cyp51A mutations, efflux pump upregulation, FKS-mediated echinocandin resistance, and biofilm-associated tolerance. We review strengths and gaps in diagnostics, including tiered essential diagnostic packages, resistance-aware molecular platforms, and early experience with GLASS Fungi and environmental surveillance. Finally, we discuss the constrained antifungal pipeline, novel agents and vaccines in development, and principles of antifungal stewardship aligned with improved access and agricultural regulation. We conclude with research and policy priorities to operationalize the WHO Fungal Priority Pathogens List and to embed fungal threats within broader antimicrobial resistance strategies, climate adaptation planning, and health system strengthening.

Background: Hepatitis B virus (HBV) and hepatitis C virus (HCV) infections are major contributors to liver disease and hepatocellular carcinoma (HCC), affecting millions worldwide. Transmission routes and clinical outcomes vary between the two viruses, with both posing significant challenges in transplantation. Understanding the seroprevalence of HBV and HCV is crucial for effective pre-transplant screening and post-transplant management to prevent disease transmission and recurrence. The present study aimed to investigate the prevalence of HBV and HCV in potential donors referred to the Iranian Tissue Bank and Research Center (ITBRC).
Methods: The study population was potential donors referred to ITBRC between 2014 and 2021, including two groups: brain death donors and forensic donors referred from the Iranian Legal Medicine Organization. For HBV, HBsAg and HBsAb; and for HCV, HCV-Ab were detected by ELISA.
Results: A total of 3862 individuals were studied (32.4% female and 67.6% male), including 1349 (34.9%) brain death and 2513 (65.1%) circulatory death donors. Analysis showed 1.19 times higher rates of HCV infection in women than in men, but this was not statistically significant. Logistic regression showed no significant effects of donor type on HCV infection rates. For HBV, brain death subjects had over three times higher odds of HBsAg-positive tests compared to circulatory death (OR = 3.06, p-value < 0.05). Additionally, female cases had lower odds of an HBsAg-positive test compared to males (OR = 0.56). The odds of a positive HBsAg test in brain death cases were 2.7 times higher than in circulatory death, with 3.49% of cases being positive for HBsAg and HBsAb test results.
Conclusion: In conclusion, this retrospective study demonstrated a higher prevalence of HBV-positive tests in brain death donors compared to circulatory death donors, with female donors showing lower odds of HBsAg-positive tests compared to males.

Merkel cell carcinoma (MCC) is a life-threatening, aggressive cancer. MCV genome integration into epidermal keratinocytes or dermal fibroblasts leads to polyomavirus-associated MCC (MCCP). Many cancer types show an increased amount of reactive oxygen species (ROS) in the growing and metastatic phases. An increase in the oxidative stress pathway results in an elevated amount of ROS. It is supposed that MCV uses the same mechanisms for inducing cancer. It can be considered that viral MCCs could be the result of oxidative stress pathways in the MCC-causing viral agent, the Merkel cell polyomavirus (MCPyV). The objective of this study was to examine the role of oxidative stress in cancers associated with Merkel cell polyomavirus (MCV). The search strategy was performed in PubMed, NCBI, Google Scholar, EMBASE, and Medline on cancer, oxidative stress, and gene manipulation up to 10 June 2022 by searching the following keywords: MCV, oxidative stress, cancer, and MCC. The cells’ uncontrolled increase in ROS amounts results in difficulties including changes in genome structure and instability. Some of these changes account for unwanted replication and inflammation in damaged cells. This investigation of the oxidative stress pathway and its role in MCC highlights new approaches for cancer therapy methods. These free radicals have been proposed to significantly contribute to DNA damage, and reactive oxygen species (ROS) are considered key mediators in the development of Merkel cell carcinoma.